Pain in the neck after neck dissection

BACKGROUND: Reports of disability after neck dissection have been directed toward shoulder dysfunction and pain. We could find no report addressing th e issue of pain localized to the actual operative site. We have conducted a combined prospective and retrospective study of pain in patients undergoin g neck dissection. METHODS: Eighty-eight disease-free patients were evaluated in 3 groups for neck pain. One group was followed up prospectively for 1 to 8 months after surgery, and 2 retrospective groups were followed up for more than 2 years or for 6 months to 2 years. Pain was assessed by a body map and visual anal og scale. RESULTS: None of 31 patients followed up for more than 2 years reported nec k pain. Four of 27 patients followed up for 6 to 24 months had pain, with a mean visual analog scale score of 3.7. Seventy percent of the prospective group of 30 patients had pain during the first postoperative week, and only 1 patient had pain persisting for more than 2 months. Shoulder pain and di sability after radical neck dissection were encountered in all groups, comp arable with the incidence reported in the literature. No postoperative neur omas were found. CONCLUSIONS: Chronic pain localized to the operative site is an uncommon oc currence even after radical neck dissection. Chronic pain in the shoulder r egion may follow radical neck dissection, whereas modified neck dissection is usually a painless procedure.